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Fruit and Dairy Intake Is Associated with a Lower Risk of Elevated Blood Pressure in Adults in Sao Paulo, Brazil †

School of Public Health, University of Sao Paulo, São Paulo 01246-904, Brazil
Author to whom correspondence should be addressed.
Presented at the 14th European Nutrition Conference FENS 2023, Belgrade, Serbia, 14–17 November 2023.
Proceedings 2023, 91(1), 306;
Published: 8 February 2024
(This article belongs to the Proceedings of The 14th European Nutrition Conference FENS 2023)


Background and objectives: Healthy eating patterns assessed by diet quality indexes (DQI) have been associated with a lower risk of elevated blood pressure (BP). However, DQI are based on different methodologies, and identifying specific components associated with BP may provide a better understanding of the population’s dietary profile for targeted interventions. The objective of this study was to examine the association between elevated BP and components of four established DQI: the 2015 Healthy Eating Index (HEI), the Dietary Approaches to Stop Hypertension (DASH), the Alternative Healthy Eating Index (AHEI), and the Brazilian Healthy Eating Index (BHEI). Methods: The study sample comprised adults aged 19 years and older (n = 1235) from the 2015 Health Survey of São Paulo with Focus on Nutrition, a cross-sectional population-based study in São Paulo City, Brazil. Dietary intake was assessed through 24 h recalls, and diet quality was estimated by adherence to HEI, DASH, AHEI, and BHEI components. The National Cancer Institute method was used to estimate the usual intake of food and nutrients. Multiple logistic regression models were used to investigate associations of BP with components of each DQI, adjusted by sociodemographic, lifestyle, and dietetic variables. Analyses were performed in Stata 14.2, and considered statistical significance at p < 0.05. Results: Higher scores in all DQI investigated were associated with being older, female, self-identifying as White or Asian, having higher household income per capita, and being classified as an under-reporter. Individuals with higher scores in dairy components (HEI: OR 0.81, 95%CI 0.70–0.92; BHEI: OR 0.83, 95%CI 0.72–0.96; DASH: OR 0.76, 95%CI 0.60–0.97), and fruit components (HEI: OR 0.72, 95%CI 0.56–0.92; BHEI: OR 0.77, 95%CI 0.61–0.98; AHEI: OR 0.82, 95%CI 0.67–0.99) had a lower occurrence of elevated BP. Discussion: Our findings suggest that the consumption of fruit and dairy within DQI recommendations may provide health benefits regarding BP. The disparities in diet quality across sociodemographic groups of adults in São Paulo City indicate the need for public health messages toward improving food consumption, particularly among those with greater vulnerability.

Author Contributions

Conceptualization, data management, formal analysis, and writing—original draft preparation, P.V.F.; Writing—review and editing, P.V.F., J.L.P., F.M.S., M.M.R. and R.M.F.; supervision, data curation, R.M.F.; project administration, F.M.S., M.M.R. and R.M.F. All authors have read and agreed to the published version of the manuscript.


This study was supported by the São Paulo Municipal Health Department (grant number 2013-0.235.936-0), the São Paulo Research Foundation (grant numbers 2012/22113-9, 2017/05125-7), the National Council for Scientific and Technological Development (grant number 472873/2012-1). Additional support was provided by the São Paulo Research Foundation (grant number 2020/07749–0) to P.V.F.

Institutional Review Board Statement

This investigation was performed in accordance with the Brazilian Law #5534 from 14 November 1968, which guarantees the confidentiality of the information collected by all national censuses. All ethical principles laid down in the Declaration of Helsinki and in the Brazilian Resolution Number 196/96 on research involving human subjects were followed. The 2015 ISA-Capital (protocols 36607614.5.0000.5421), as well as the present study (protocols 48960621.9.0000.5421), were approved by the Institutional Review Board of the School of Public Health, University of São Paulo.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy.

Conflicts of Interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
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MDPI and ACS Style

Felix, P.V.; Pereira, J.L.; Sarti, F.M.; Rogero, M.M.; Fisberg, R.M. Fruit and Dairy Intake Is Associated with a Lower Risk of Elevated Blood Pressure in Adults in Sao Paulo, Brazil. Proceedings 2023, 91, 306.

AMA Style

Felix PV, Pereira JL, Sarti FM, Rogero MM, Fisberg RM. Fruit and Dairy Intake Is Associated with a Lower Risk of Elevated Blood Pressure in Adults in Sao Paulo, Brazil. Proceedings. 2023; 91(1):306.

Chicago/Turabian Style

Felix, Paula Victoria, Jaqueline Lopes Pereira, Flavia Mori Sarti, Marcelo Macedo Rogero, and Regina Mara Fisberg. 2023. "Fruit and Dairy Intake Is Associated with a Lower Risk of Elevated Blood Pressure in Adults in Sao Paulo, Brazil" Proceedings 91, no. 1: 306.

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